Body mass index and blood volume influence plasma biomarkers and positron emission tomography classification in preclinical Alzheimer's disease

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-10-11 DOI:10.1002/alz.70765

Tovia Jacobs, Courtney O’ Brien, Luisa Figueredo, Alexandra Gogola, Naomi L. Gaggi, Brian Hurwitz, Elizabeth Pirraglia, Shimon Herzog, Jaime Ramos-Cejudo, Timothy M. Shepherd, Priya Palta, Juan Fortea, Thomas M Wisniewski, Rebecca A. Betensky, Brian Lopresti, Michelle M. Mielke, Antonio Convit, Ricardo S. Osorio, for the Alzheimer's Disease Neuroimaging Initiative

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引用次数: 0

Abstract

INTRODUCTION

Blood-based biomarkers (BBMs) are promising tools for Alzheimer's disease (AD) diagnosis, but their accuracy may be affected by body mass index (BMI) and blood volume (BV) through dilution. We investigated how BMI and BV influence BBM concentrations and PET prediction.

METHODS

Data from 241 cognitively unimpaired participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were examined to evaluate the influence of BMI/BV on BBMs (Aβ_42/40, p-Tau₁₈₁, p-Tau₂₁₇, glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL]) and BBM-based PET predictions.

RESULTS

Elevated BMI/BV associated with lower BBM concentrations, especially for p-Tau₂₁₇ and NfL, independent of brain amyloid burden. BMI-stratified thresholds improved amyloid PET prediction, with higher BBM thresholds and area under the curve (AUC) values seen in normal weight compared to overweight or obese participants. Drastic BMI/BV declines due to weight loss increased BBM variability and systematic PET misclassification.

DISCUSSION

Adjusting for BMI/BV in BBM-based diagnostics appears to improve accuracy and reliable detection of AD pathology, especially in preclinical stages.

Highlights

Body mass index (BMI) and blood volume (BV) significantly influenced plasma BBM concentrations in cognitively unimpaired (CU) individuals.
Blood-based biomarkers (BBMs) associated more strongly with BV than with BMI.
Dilution effects were independent of brain amyloid burden.
BMI-stratified BBM thresholds improved amyloid positron emission tomography (PET) classification accuracy.
Declines in BMI/BV resulted in PET prediction bias and systematic errors.

Abstract Image

查看原文本刊更多论文

体重指数和血容量影响临床前阿尔茨海默病的血浆生物标志物和正电子发射断层扫描分类。

基于血液的生物标志物（BBMs）是诊断阿尔茨海默病（AD）的有前途的工具，但其准确性可能受到身体质量指数（BMI）和血容量（BV）稀释的影响。我们研究了BMI和BV如何影响BBM浓度和PET预测。方法：研究了241名阿尔茨海默病神经影像学倡议（ADNI）中认知功能未受损的参与者的数据，以评估BMI/BV对脑卒中（Aβ42/40、p-Tau181、p-Tau217、胶质纤维酸性蛋白[GFAP]、神经丝轻链[NfL]）和基于脑卒中的PET预测的影响。结果：BMI/BV升高与BBM浓度降低相关，尤其是p-Tau217和NfL，与脑淀粉样蛋白负荷无关。bmi分层阈值提高了淀粉样蛋白PET预测，与超重或肥胖参与者相比，正常体重的BBM阈值和曲线下面积（AUC）值更高。体重减轻导致的BMI/BV急剧下降增加了BBM变异性和系统性PET错误分类。讨论：在基于BMI/BV的诊断中，调整BMI/BV似乎提高了AD病理检测的准确性和可靠性，特别是在临床前阶段。重点：身体质量指数（BMI）和血容量（BV）显著影响认知未受损（CU）个体的血浆BBM浓度。基于血液的生物标志物（BBMs）与BV的相关性强于与BMI的相关性。稀释效应与脑淀粉样蛋白负荷无关。bmi分层BBM阈值提高了淀粉样正电子发射断层扫描（PET）分类的准确性。BMI/BV的下降导致PET预测偏差和系统误差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.